Confusion medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Overview

Complete evaluation of the patient in an emergency department has to be done, which is followed by the administration of appropriate treatment. Every confused individual should be administered with glucose and thiamine, followed by naloxone and flumazenil. Treatment must be started while waiting for the results. Early treatment can save the individual from long term effects.

Medical Therapy

Treatment of confusion starts from the emergency department itself. Initial assessment of the airway, breathing, and circulation are important and they have to be managed. Treatment most often depends on the suspected cause of confusion.

• Alcoholics are primarily treated with glucose and thiamine.
• Dehydrated individuals are treated with IV saline infusions.
• Electrolyte abnormalities are treated adequately.
• Renal and hepatic failure, if present, have to be consulted for by experts for further management.
• Close monitoring of patients is warranted in patients who develop symptoms after hospital admission.
• Required consults such as with a neurologist, a psychiatrist, or an infectious disease physician are ordered.
• If infections are suspected, empiric therapy has to be administered.
• If there is suspicion of drug overdose or abuse, antagonists should be administered.
• In cases of poisoning with sleeping pills, flumazenil can be used to reverse the effects.

References

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